TANNER LEE BOLES (NPI# 1104247279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104247279 |
| Entity Type | Individual |
| Full Name | TANNER LEE BOLES |
| Credential | M.A. |
| Practice Address |
1390 S Douglas Blvd 102 Midwest City OK 73130-5270 |
| Practice Telephone | 4054555312 |
| Mailing Telephone | 4054555312 |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2013-12-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
4638 | OK | Behavioral Health & Social Service Providers |
| Street Address |
1390 S DOUGLAS BLVD 102 |
| City | MIDWEST CITY |
| State | OK |
| Zip Code | 73130-5270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073848693 | Deborah Moos | Rehabilitation Counselor | 1390 S Douglas Blvd, Ste 102, Midwest City, OK 73130-5270 | 2009-10-15 |
| 1770107906 | Stephanie Lizett Rivas | Case Manager/Care Coordinator | 1390 S Douglas Blvd, Midwest City, OK 73130-5270 | 2020-06-03 |
| 1659917060 | Terri Lynn Marino | Counselor | 1390 S Douglas Blvd, Midwest City, OK 73130-5270 | 2019-11-20 |
| 1245794411 | Oklahoma Psychiatric Family Clinic | Clinic/Center | 1390 S Douglas Blvd, Midwest City, OK 73130-5270 | 2019-01-22 |
| 1265908370 | Melissa Anne Koehler | Counselor | 1390 S Douglas Blvd, Midwest City, OK 73130-5270 | 2018-10-16 |
| 1083104376 | Brenda Kitchen | Counselor | 1390 S Douglas Blvd, Midwest City, OK 73130-5270 | 2018-05-13 |
| 1043758295 | Candace R Jones | Counselor | 1390 S Douglas Blvd, Ste 102, Midwest City, OK 73130-5270 | 2017-02-08 |
| 1780094870 | Shereena Burnett | Behavioral Analyst | 1390 S Douglas Blvd, Suite 102, Midwest City, OK 73130-5270 | 2014-04-29 |
| 1871916023 | Claudia Rivas-taylor | Behavioral Analyst | 1390 S Douglas Blvd, Suite 102, Midwest City, OK 73130-5270 | 2014-01-23 |
| 1497005169 | Stephanie Camacho | Counselor | 1390 S Douglas Blvd, Midwest City, OK 73130-5270 | 2012-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366059909 | Richard Williams | Behavior Technician | 1121 S. Douglas Boulevard, Suite A, Midwest City, OK 73130 | 2020-09-28 |
| 1730794264 | Cassidy Myers | Behavioral Analyst | 1121 South Douglas Boulevard, Suite A, Midwest City, OK 73130 | 2020-09-11 |
| 1831609320 | Progressive Home Health Inc | Home Health | 9070 Harmony Dr Ste C, Midwest City, OK 73130 | 2017-10-10 |
| 1306290903 | Maria Soledad Dabney | Counselor | 9101 Stonegate, Oklahoma City, OK 73130 | 2016-04-20 |
| 1922452804 | Endodontics and Implant Associates,pllc | Dentist | 1621 Midtown Place, Suite B, Midwest City, OK 73130 | 2016-04-18 |
| 1639574130 | Healthcare Express, LLP | Clinic/Center | 1701 S. Douglas Blvd., Midwest City, OK 73130 | 2014-10-27 |
| 1891045274 | Michelle Lynn Goolsby | Behavioral Analyst | 10822 Blue Sky Drive, Midwest City, OK 73130 | 2012-09-13 |
| 1497026173 | Deberry Interprise | Community/Behavioral Health | 9233 North East10th Street, Midwest City, OK 73130 | 2012-01-26 |
| 1245531789 | Nichelle Stewart | Counselor | 10520 Quail Run Road, Midwest City, OK 73130 | 2010-11-16 |
| 1477877835 | Jan Bierne, Inc. | Counselor | 2912 S. Douglas Blvd, Suite A, Midwest City, OK 73130 | 2010-03-15 |
| Find all providers in zip 73130 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114419330 | Shitavia Skanes | Counselor | 5710 E Reno Ave, Midwest City, OK 73110-2005 | 2018-06-04 |
| 1992227078 | Charmaine Lashawn Hillard | Counselor | 10400 Caton Pl, Midwest City, OK 73130-1633 | 2017-07-11 |
| 1285179473 | Christina Austin | Counselor | 2801 Parklawn Dr Ste 201, Midwest City, OK 73110-4229 | 2016-12-27 |
| 1811431687 | Kevon Owen | Counselor | 804 Fairlane Dr, Midwest City, OK 73110-1630 | 2016-12-13 |
| 1811443872 | Brittney Coulter | Counselor | 6267 E Reno Ave, Apt A, Midwest City, OK 73110-2059 | 2016-08-30 |
| 1770976268 | Tammy Lozano | Counselor | 9409 Ne 13th St, Midwest City, OK 73130-1211 | 2015-03-09 |
| 1518371095 | Deanna Gaines | Counselor | 11611 Elmhurst Dr, Midwest City, OK 73130-8431 | 2014-06-12 |
| 1669890869 | Natasha Broadie | Counselor | 302 Hudson Pl, Midwest City, OK 73110-7755 | 2014-04-03 |
| 1659707040 | Nealett Henderson | Counselor | 3816 Rosewood Ct, Midwest City, OK 73110-3456 | 2013-09-18 |
| 1043644362 | Karen Hood | Counselor | 305 E Kittyhawk Dr, Midwest City, OK 73110-5309 | 2013-08-22 |
| Find all providers in MIDWEST CITY | ||||
| City | MIDWEST CITY |
| Zip Code | 73130 |
Please comment or provide details below to improve the information on TANNER LEE BOLES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.